Pancreatic ductal adenocarcinoma: exploring clinicopathological trends and racial disparities in a comprehensive U.S. population‑based study

• Abdul Qahar Khan Yasinzai ^[4] ; Bisma Tareen ^[4] ; Nimra Jamil ^[4] ; Hafeez Ullah ^[4] ; Muhammad Raza ^[4] ; Amin Ullah Khan ^[4] ; Katharine Tracy ^[5] ; Marjan Khan ^[6] ; Abdul Waheed ^[7] ; Feroze Sidhwa ^[7] ; Subhasis Misra ^[8] ; Nabin Raj Karki ^[1] ; Nagla Abdel Karim ^[2] ; Dauod Arif ^[9] ; Ludimila Cavalcante ^[9] ; Asad Ullah ^[3]
  1. [1] University of South Alabama

     University of South Alabama

     Estados Unidos

     
  2. [2] University of Virginia

     University of Virginia

     Estados Unidos

     
  3. [3] Texas Tech University Health Sciences Center

     Texas Tech University Health Sciences Center

     Estados Unidos

     
  4. [4] Miller KD, Ortiz AP, Pinheiro PS, Bandi P, Minihan A, Fuchs HE, et al. Cancer statistics for the US Hispanic/Latino population, 2021. CA Cancer J Clin. 2021;71(6):466–87.
  5. [5] Medical College of Georgia, Augusta, GA 30912, USA
  6. [6] Internal Medicine, Marshfield Medical Center, Marshfield, USA
  7. [7] Department of Surgery, San Joaquin General Hospital, French Camp, CA 95231, USA
  8. [8] Department of Surgery, BayCare Health System, Tampa, FL, USA
  9. [9] Department of Oncology Developmental Therapeutics, Novant Health, Charlotte, NC, USA

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 10, 2024, págs. 2618-2628
• Idioma: inglés
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• Resumen

  • Introduction Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy about 50% of PDAC are metastatic at presentation. In this study, we evaluated PDAC demographics, annual trend analysis, racial disparities, survival rate, and the role of different treatment modalities in localized and metastatic disease.

    Methods A total of 144,824 cases of PDAC were obtained from the SEER database from 2000 to 2018.

    Results The median age was 69 years, with a slightly higher incidence in males (52%) and 80% of all cases were white. Among cases with available data, 43% were grade III tumors and 57% were metastatic. The most common site of metastasis was the liver (15.7%). The annual incidence has increased steadily from 2000 to 2018. The overall observed (OS) 5-year survival rate was 4.4% (95% CI 4.3–4.6%), and 5 years cause-specific survival (CSS) was 5% (95% CI 5.1–5.4%). The 5-year survival with multimodal therapy (chemotherapy, surgery, and radiation) was 22% (95% CI 20.5–22.8%). 5-year CSS for the blacks was lower at 4.7% (95% CI 4.2–5.1%) compared to the whites at 5.3% (95% CI 5.1–5.4%). Multivariate analysis found male gender and black race associated with worse prognosis. Kaplan–Meier survival analysis found multimodal therapy to have the best outcomes in all three stages.

    Conclusion PDAC is an aggressive malignancy with male gender and black race are associated with a poor prognosis. Sur- gery with chemoradiation was associated with the best overall survival. With steadily increasing rates of PDAC, improved treatment modalities are paramount to improving survival in these patients.